Smoking status and lung function in rural areas of northern Greece

<bold>Background:</bold> Smoking impairs lung function in genetically predisposed individuals. <bold>Objective:</bold> Assessment of smoking status and lung function in a rural population. <bold>Methods:</bold> We performed a cross-sectional study in rural areas of northern Greece, including participants >35 years old, without previously diagnosed COPD or other respiratory disorders. The study was conducted under the auspices of Hellenic Chest Diseases Society. <bold>Results:</bold> Among 970 participants (63.6±12.6, range 35-92 years), 38.9% were men (66.1±12.9 years) and 61.1% women (61.9±12.2 years). Never-smokers comprised 40.9%, former-smokers 21.8% and current smokers 37.3% of participants. Current smokers were younger than former- and never-smokers (58.2±12 vs 66.7±12 years, p<0.01). Smoking status >30 pack-years (py) accounted for 47.8%, 20-30py for 30.7%, 10-20py for 15.4% and <10py for 6.2% of current smokers. Never-smokers showed slightly higher FEV1/FVC compared to former smokers (0.83±0.1 vs 0.81±0.1, p=0.04), without difference in FEV1%predicted (97.8±20.0 vs 95.3±24.2, p=0.22); similarly compared to smokers >30py (FEV1/FVC: 0.81±0.1, p<0.01 / FEV1%predicted: 97.8±18.2, p=0.99), and to smokers 20-30py (0.81±0.1, p=0.02 / 98.2±2, p=0.84). Never-smokers had similar lung function to smokers 11-20py (0.84±0.1, p=0.11 / 102.4±22.1, p=0.13), although the latter were significantly younger (48.4±12.3 vs 67.6±11.4 years, p<0.01), and to smokers <10py (0.81±0.1, p=0.38 / 105.4±20.6, p=0.09) despite the age difference (52.6±15.4 years, p<0.01). Among current smokers, 19.8% presented with clinical and spirometric findings compatible with COPD. <bold>Conclusion:</bold> Smoking impairs lung function. Assessment of the small airways is necessary to capture incipient deterioration.